With the rise in elbow and shoulder injuries in youth baseball pitchers,
the adult community needs to take steps to prevent these injuries.
Research points to overuse as the principle risk factor. Poor pitching
mechanics also contribute to injury risk. Another suggested risk factor is
poor physical fitness.
Throwing curveballs has been suggested as a risk factor, but the
existing research does not support this concern. However, a youth pitcher
may not have enough physical development, neuromuscular control, and
proper coaching instruction to throw a curveball with good mechanics.
Throwing curveballs too early may be counter-productive, leading to arm
fatigue as well as limiting the youth's ability to master fastball
mechanics.
Thus, the recommendations for preventing injuries in youth baseball
pitchers are:
- Watch and respond to signs of fatigue. If a youth pitcher complains
of fatigue or looks fatigued, let him rest from pitching and other
throwing.
- No overhead throwing of any kind for at least 2-3 months per year (4
months is preferred). No competitive baseball pitching for at least 4
months per year.
- Do not pitch more than 100 innings in games in any calendar year.
- Follow limits for pitch counts and days rest. (Example limits
are shown in the table below.)
- Avoid pitching on multiple teams with overlapping seasons.
- Learn good throwing mechanics as soon as possible. The first steps
should be to learn, in order: 1) basic throwing, 2) fastball pitching,
3) change-up pitching.
- Avoid using radar guns.
- A pitcher should not also be a catcher for his team. The
pitcher-catcher combination results in many throws and may increase
the risk of injury.
- If a pitcher complains of pain in his elbow or shoulder, get an
evaluation from a sports medicine physician.
- Inspire youth pitchers to have fun playing baseball and other
sports. Participation and enjoyment of various physical activities
will increase the youth's athleticism and interest in sports.
Example
limits for number of pitches thrown in games
Age (yrs)
|
2006 USA Baseball Guidelines
|
2010 Little League Baseball Regulations
|
Daily limits
|
17-18
|
n/a
|
105/day
|
15-16
|
n/a
|
95/day
|
13-14
|
75/game
|
11-12
|
75/game
|
85/day
|
9-10
|
50/game
|
75/day
|
7-8
|
n/a
|
50/day
|
Weekly limits
|
13-14
|
125/wk; 1000/season; 3000/yr
|
|
11-12
|
100/wk; 1000/season; 3000/yr
|
9-10
|
75/wk; 1000/season; 2000/yr
|
7-18
|
|
21-35 pitches --> 1 day rest;
36-50
pitches --> 2 days rest;
51-65
pitches --> 3 days rest
66-
pitches --> 4 days rest
|
References:
- Dun S, Loftice J, Fleisig GS, Kingsley D, Andrews JR.
A biomechanical comparison of youth baseball pitches: is the curveball
potentially harmful? Am J Sports Med. 2008; 36(4):686-692.
- Fleisig GS, Andrews JR, Cutter GR, Weber A, Loftice
J, McMichael C, Hassell N, Lyman S. Risk of serious injury for young
baseball pitchers: a 10-year prospective study. Am J Sports Med.
2011; 39(2):253-257.
- Fleisig GS, Andrews JR, Dillman CJ, Escamilla RF.
Kinetics of baseball pitching with implications about injury
mechanisms. Am J Sports Med. 1995; 23:233-239.
- Fleisig GS, Weber A, Hassell N, Andrews JR.
Prevention of elbow injuries in youth baseball pitchers. Curr
Sports Med Rep 2009; 8(5):250-254.
- Lyman S, Fleisig GS, Andrews JR, Osinski ED. Effect
of pitch type, pitch count, and pitching mechanics on risk of elbow
and shoulder pain in youth baseball pitchers. Am J Sports Med.
2002; 30(4):463-468.
- Matsuo T, Fleisig GS, Zheng N, Andrews JR. Influence
of shoulder abduction and lateral trunk tilt on peak elbow varus
torque for college baseball pitchers during simulated pitching. J
Appl Biomech. 2006; 22(2): 93-102.
- Nissen CW, Westwell M, unpuu S, Patel M, Solomito
M, Tate J. A biomechanical comparison of the fastball and curveball in
adolescent baseball pitchers. Am J Sports Med. 2009
37(8):1492-1498.
- Olsen SJ, Fleisig GS, Dun S, Loftice J, Andrews JR.
Risk factors for shoulder and elbow injuries in adolescent baseball
pitchers. Am J Sports Med. 2006; 34(6):905-912.
- Petty DH, Andrews JR, Fleisig GS, et al. Ulnar
collateral ligament reconstruction in high school baseball players:
clinical results and injury risk factors. Am J Sports Med 2004;
32:1158-1164.
Comments on this position statement: here
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